The Influence of Nanobubble Size and Stability on Ultrasound Enhanced Drug Delivery

Ultrasound-Triggered NPC1L1-Targeting Nanobubbles for Remodeling the Tumor Microenvironment in Pancreatic Cancer Chemoimmunotherapy

Abnormal cholesterol metabolism promotes the immunosuppressive microenvironment of pancreatic cancer and affects the long-term efficacy of chemotherapy drugs. Accurate diagnosis and targeted microenvironment-remodeling are challenging during the asymptomatic phase, considerably weakening the antitumor response. To modulate the cholesterol uptake pathway in pancreatic cancer, we developed a seamless diagnostic and chemoimmunotherapy system comprising gemcitabine-loaded nanobubbles with a cholesterol component shell (CHOL@GEM-NBs) fabricated to target the cholesterol transporter Niemann-Pick C1-like 1 (NPC1L1) precisely. The system achieved sufficient permeability to enhance the targeted accumulation of NBs extravasation in tumor blood vessels to locate the tumor region. The CHOL@GEM-NBs exhibited excellent ultrasound molecular imaging performance, with increased contrast intensity and duration time. Moreover, we employed ultrasound-targeted nanobubble destruction (UTND) to facilitate cytotoxicity by enhancing cellular uptake and drug release. This approach reduced NPC1L1 expression and mitigated cholesterol hijacking by tumor cells in the microenvironment. Additionally, ultrasound and cavitation triggered immunogenic cell death to release damage-associated molecular patterns. Essential cholesterol flow restoration and adaptive immunity activation improved the immunosuppressive microenvironment, as evidenced by the increased infiltration of CD8+ cytotoxic T lymphocytes, increased cytokine secretion, decreased proportion of regulatory T cells in tumor tissues, and increased proportions of CD45+, CD3+, and CD8+ T cells in the spleen and draining lymph nodes. In conclusion, the combined CHOL@GEM-NBs and UTND strategy can effectively permeate and reshape the immunosuppressive microenvironment, offering a novel integrated approach for the early diagnosis and chemoimmunotherapy of pancreatic cancer.

Enhancing ultrasound applications through shell-less nanobubbles: A study on acoustic and optical properties

Histotripsy employs acoustic inertial cavitation to mechanically destroy tissue, producing acellular debris. While introducing bubbles can lower the cavitation threshold and enhance treatment efficiency, micrometer-scale bubbles struggle to penetrate tissues effectively. Shell-less nanobubbles, with their high internal pressure, stability, negatively charged surfaces, and unique lifetimes ranging from weeks to months, offer a promising alternative. However, their interactions with ultrasound remain unexplored. This study used a claw-type pump nanobubble generator to produce nanobubbles and employed acoustic and optical methods to observe their behavior under high-intensity ultrasound exposure. The results demonstrated that the device generated nanobubble solutions with an average particle size of 107 nm, a concentration of 1.94 × 109 particles/mL, a lifetime exceeding one week, and a zeta potential of -21.2 mV. Acoustic and optical observations further revealed that nanobubble solutions reduced the inertial cavitation threshold of the liquid from 26.5 MPa to 10.3 MPa. These findings suggest a potential strategy to enhance the efficiency of ultrasound histotripsy treatments.

Current developments in diverse biomaterial formulations for ultrasound-mediated drug delivery

In this review, we focus on advances in drug delivery systems (DDSs) pertaining to modern therapeutics, with a particular emphasis on the role of ultrasound (US)-mediated drug delivery (UMDD). We highlight the need for advanced systems in response to several challenges, such as the diversity of pharmacological agents and individual patient variations, over traditional methodologies. We detail the mechanisms of UMDD (thermal and mechanical), and discuss various material formulations suitable for UMDD. We also discuss new perspectives on the potential of US to innovate drug delivery methodologies and improve patient outcomes to emphasize the importance of development to enhance treatment effectiveness.

Progress and potential of nanobubbles for ultrasound-mediated drug delivery

INTRODUCTION

Despite much progress, nanomedicine-based drug therapies in oncology remain limited by systemic toxicity and insufficient particle accumulation in the tumor. To address these barriers, formulations responsive to external physical stimuli have emerged. One most promising system is the ultrasound stimulation of drug-loaded, gas-core particles (bubbles). Ultrasound induces bubble cavitation for cell and tissue permeabilization, triggers on-demand drug release, and provides opportunities for real-time imaging of delivery.

AREAS COVERED

Here, we focus on shell-stabilized, gas-core nanoparticles (also termed nanobubbles or ultrafine bubbles) and their role in ultrasound-mediated therapeutic delivery to tumors. This review frames the advantages of nanobubbles within the ongoing deficits in nanomedicine, describes mechanisms of ultrasound-mediated therapy, and details formulation techniques for nanobubble delivery systems. It then highlights the past decade of research in nanobubble-facilitated drug delivery for cancer therapy and anticipates new directions in the field.

EXPERT OPINION

Nanobubble ultrasound contrast agents offer a spatiotemporally triggerable therapeutic coupled with a safe, accessible imaging modality. Nanobubbles can be loaded with diverse therapeutic cargoes to treat disease and overcome numerous barriers limiting delivery to solid tumors. Close attention to formulation, characterization methods, acoustic testing parameters, and the biological mechanisms of nanobubble delivery will facilitate preclinical research toward clinical adoption.

Early Time Spreading Dynamics of Nanobubble-Laden Drops

Nanobubbles, when dispersed in a liquid phase, may enhance mass transport, adsorption, and reactions in many industrial applications, such as fabrication of functional materials, drug delivery, water treatment, carbon dioxide capture, and surface decontamination. Here, we experimentally study the early time spreading dynamics of nanobubble-laden surfactant drops on a hydrophilic solid surface submerged in an oil phase. Along with recovering the retarding effects of surfactants on the early time wetting dynamics, we report that nanobubbles can weaken Marangoni stresses and consequently reduce the duration of the retardation regime. Remarkably, we find that the duration of this retardation regime (tr) exponentially decays with the nanobubble concentration in the dispersion (Nb) according to Nb ∼ log(1/tr). The micro-particle imaging velocimetry analysis of the flow field inside the drop indicates a large reduction in the magnitude of velocities in the presence of surface-active materials, confirming the existence of Marangoni flow that opposes droplet spreading. Our research introduces a simple approach to calculate the nanobubble concentrations in liquids and offers guidelines for controlling wetting dynamics.

Strategy to relieve cellular oxidative stress based on ultra-small nanobubbles without exogenous antioxidants

Reactive oxygen species (ROS) produced in living systems are essential to physiological processes. However, excess ROS in the organism (oxidative stress) damages crucial cell components, leading to many diseases. Although some commercial antioxidants can counteract ROS damage, their inadequate tissue penetration, disruption of normal ROS functions, and possible toxicity have led to disappointing results in clinical trials for ROS-induced chronic diseases. Thus, new antioxidant strategies are warranted. Herein, we report a novel "antioxidant" composed of pure nitrogen gas in an ultra-small nanobubble (UNB) form, which can relieve oxidative stress in cells. Our results indicate that UNBs can reduce cellular ROS levels under oxidative stress and increase survival and proliferation. Besides, UNBs can decrease the oxidative damage to cellular biomacromolecules (lipids, proteins, and nuclear acids). Thus, UNBs are a promising nonchemical antioxidative strategy with potential applications against oxidative stress-related diseases and without the natural defect of chemical antioxidants.

Assessing Therapeutic Nanoparticle Accumulation in Tumors Using Nanobubble-Based Contrast-Enhanced Ultrasound Imaging

This study explores the challenges associated with nanoparticle-based drug delivery to the tumor parenchyma, focusing on the widely utilized enhanced permeability and retention effect (EPR). While EPR has been a key strategy, its inconsistent clinical success lacks clear mechanistic understanding and is hindered by limited tools for studying relevant phenomena. This work introduces an approach that employs multiparametric dynamic contrast-enhanced ultrasound (CEUS) with a nanoscale contrast agent for noninvasive, real-time examination of tumor microenvironment characteristics. We demonstrate that CEUS imaging can: (1) evaluate tumor microenvironment features, (2) be used to help predict the distribution of doxorubicin-loaded liposomes in the tumor parenchyma, and (3) be used to predict nanotherapeutic efficacy. CEUS using nanobubbles (NBs) was carried out in two tumor types of high (LS174T) and low (U87) vascular permeability. LS174T tumors consistently showed significantly different time intensity curve (TIC) parameters, including area under the rising curve (AUCR, 2.7×) and time to peak intensity (TTP, 1.9×) compared to U87 tumors. Crucially, a recently developed decorrelation time (DT) parameter specific to NB CEUS dynamics successfully predicted the distribution of doxorubicin-loaded liposomes within the tumor parenchyma (r = 0.86 ± 0.13). AUCR, TTP, and DT were used to correlate imaging findings to nanotherapeutic response with 100% accuracy in SKOV-3 tumors. These findings suggest that NB-CEUS parameters can effectively discern tumor vascular permeability, serving as a biomarker for identifying tumor characteristics and predicting the responsiveness to nanoparticle-based therapies. The observed differences between LS174T and U87 tumors and the accurate prediction of nanotherapeutic efficacy in SKOV-3 tumors indicate the potential utility of this method in predicting treatment efficacy and evaluating EPR in diseases characterized by pathologically permeable vasculature. Ultimately, this research contributes valuable insights into refining drug delivery strategies and assessing the broader applicability of EPR-based approaches.

Enhancing the bioavailability and activity of natural antioxidants with nanobubbles and nanoparticles

KEY POLICY HIGHLIGHTSNanobubbles and nanoparticles may enhance the polyphenols' bioavailabilityNanobubbles may stimulate the activation of Nrf2 and detox enzymesArmoured oxygen nanobubbles may enhance radiotherapy or chemotherapy effects.

Collagen nanobubbles as efficient carriers for targeted controlled release of ibrutinib

Nanobubbles are designed to increase structural stability and enhance the distribution of the transported drug to the targeted site. They can efficiently penetrate the desired area from the bloodstream due to the small size of nanobubbles. In general, the structure of the bubbles contains a gas inside, surrounded by an outer polymeric shell. In this study, perfluoropentane was utilized as a gaseous core whereas collagen was used to form shells because of its biodegradability and excellent biocompatibility. The release studies of collagen nanobubbles prepared at several drug doses were carried out in a Franz cell using a dialysis membrane at different pH (5.5-7.4) and temperature (4.0-40.0 °C) ranges. In the release experiments with collagen nanobubbles, it was observed that approximately 70% of the drug was released within 6 days at pH 7.4 whereas the same releasing rate was achieved within only 24 h after exploding by ultrasound treatment. At the same time, a cytotoxicity study was carried out to demonstrate the effectiveness of the synthesized nanobubbles. With increasing drug loading concentration and ultrasound treatment, the cytotoxic activities of nanobubbles became similar to those of the free drug (ibrutinib). Furthermore, cell culture studies were performed to assess in vitro drug-releasing efficiencies of nanobubbles by using the HeLa cell line as a model of soft cancer tissue. In conclusion, these nanobubbles could be classified as an efficient alternative to carrying active agents for treating soft tissue tumors.

Microbubble Enhanced Delivery of Vitamin C for Treatment of Colorectal Cancer

During chemotherapy treatment for cancer, often only a fraction of the administered dose reaches the tumor site, with the remaining drug spreading throughout the body, producing unwanted side-effects and restricting how much drug can be safely administered. A potential solution to reduce this problem is the use of microbubbles. The interaction between microbubbles and ultrasound generates pores in the tumor cells, permitting enhanced drug uptake. This study investigates the delivery of the ascorbic acid derivative, palmitoyl ascorbate, to KRAS-mutated colorectal cancer cells in vitro. Ultrasound-triggered microbubbles enhanced the efficacy of liposomal palmitoyl ascorbate treatments by 1.7- and 2.2-fold in LS174T and HCT116 CRC cell lines, respectively. This enhancement was achieved without increasing the drug dosage, and the therapeutic effect was shown to be localized to the area that received the ultrasound pulse, aiding in the reduction of off-site toxicity.

Nanobubble Contrast Enhanced Ultrasound Imaging: A Review

Contrast-enhanced ultrasound is currently used worldwide with clinical indications in cardiology and radiology, and it continues to evolve and develop through innovative technological advancements. Clinically utilized contrast agents for ultrasound consist of hydrophobic gas microbubbles stabilized with a biocompatible shell. These agents are used commonly in echocardiography, with emerging applications in cancer diagnosis and therapy. Microbubbles are a blood pool agent with diameters between 1 and 10 μm, which precludes their use in other extravascular applications. To expand the potential use of contrast-enhanced ultrasound beyond intravascular applications, sub-micron agents, often called nanobubbles or ultra-fine bubbles, have recently emerged as a promising tool. Combining the principles of ultrasound imaging with the unique properties of nanobubbles (high concentration and small size), recent work has established their imaging potential. Contrast-enhanced ultrasound imaging using these agents continues to gain traction, with new studies establishing novel imaging applications. We highlight the recent achievements in nonlinear nanobubble contrast imaging, including a discussion on nanobubble formulations and their acoustic characteristics. Ultrasound imaging with nanobubbles is still in its early stages, but it has shown great potential in preclinical research and animal studies. We highlight unexplored areas of research where the capabilities of nanobubbles may offer new advantages. As technology advances, this technique may find applications in various areas of medicine, including cancer detection and treatment, cardiovascular imaging, and drug delivery.

Nanobubbles and Fibroblast Growth: An In Vitro Study on Cell Migration and Proliferation

Nanobubbles are studied for their unique properties and possible applications in wound healing processes. This study investigates the effects of hydrogen (H₂), oxygen (O₂), and ozone (O₃) nanobubbles on fibroblast migration and proliferation using in vitro scratch wound healing assays. Fibroblast cells were treated with Dulbecco's Modified Eagle Medium (DMEM) combined with nanobubble solutions, and cell density was measured at 24 and 48 hours. While no significant difference was observed at 24 hours (p=0.52), ozone nanobubbles significantly reduced cell density at 48 hours (p=0.005), indicating cytotoxic effects. Hydrogen and oxygen nanobubble treatments did not show statistically significant differences from the control. These results highlight the cytotoxic effects of ozone nanobubbles on fibroblasts, which may impact their potential application in wound healing. While the study shows the cytotoxic effects of ozone nanobubbles, in vivo wound healing and antimicrobial impacts remain unexplored and warrant further study.

Low-boiling-point perfluorocarbon nanodroplets for adaptable ultrasound-induced blood-brain barrier opening

Low-boiling point perfluorocarbon nanodroplets (NDs) are valued as effective sonosensitive agents, encapsulating a liquid perfluorocarbon that would instantaneously vaporize at body temperature without the NDs shell. Those NDs have been explored for both therapeutic and diagnostic purposes. Here, phospholipid-shelled nanodroplets containing octafluoropropane (C3F8) or decafluorobutane (C4F10) formed by condensation of microbubbles were thoroughly characterized before blood-brain (BBB) permeabilization. Transmission electron microscopy (TEM) and cryo-TEM were employed to confirm droplet formation while providing high-resolution insights into the droplet surface and lipid arrangement assessed from electron density observation after condensation. The vaporization threshold of NDs was determined with a high-speed camera, and the frequency signal emitted by the freshly vaporized bubbles was analyzed using cavitation detection. C3F8 NDs exhibited vaporization at 0.3 MPa (f0 = 1.5 MHz, 50 cycles), and emitted signals at 2 f0 and 1.5 f0 from 0.45 MPa onwards (f0 = 1.5 MHz, 50 cycles), while broadband noise was measured starting from 0.55 MPa. NDs with the higher boiling point C4F10 vaporized at 1.15 MPa and emitted signals at 2 f0 from 0.65 MPa and 1.5 f0 from 0.9 MPa, while broadband noise was detected starting from 0.95 MPa. Both ND formulations were used to permeabilize the BBB in healthy mice using tailored ultrasound sequences, allowing for the identification of optimal applications for each NDs type. C3F8 NDs proved suitable and safe for permeabilizing a large area, potentially the entire brain, at low acoustic pressure. Meanwhile, C4F10 droplets facilitated very localized (400 μm isotropic) permeabilization at higher pressure. This study prompts a closer examination of the structural rearrangements occurring during the condensation of microbubbles into NDs and highlights the potential to tailor solutions for different brain pathologies by choosing the composition of the NDs and adjusting the ultrasound sequence.

Clinical Applications of Micro/Nanobubble Technology in Neurological Diseases

Nanomedicine, leveraging the unique properties of nanoparticles, has revolutionized the diagnosis and treatment of neurological diseases. Among various nanotechnological advancements, ultrasound-mediated drug delivery using micro- and nanobubbles offers promising solutions to overcome the blood-brain barrier (BBB), enhancing the precision and efficacy of therapeutic interventions. This review explores the principles, current clinical applications, challenges, and future directions of ultrasound-mediated drug delivery systems in treating stroke, brain tumors, neurodegenerative diseases, and neuroinflammatory disorders. Additionally, ongoing clinical trials and potential advancements in this field are discussed, providing a comprehensive overview of the impact of nanomedicine on neurological diseases.

A Promising Therapeutic Strategy of Combining Acoustically Stimulated Nanobubbles and Existing Cancer Treatments

In recent years, ultrasound-stimulated microbubbles (USMBs) have gained great attention because of their wide theranostic applications. However, due to their micro-size, reaching the targeted site remains a challenge. At present, ultrasound-stimulated nanobubbles (USNBs) have attracted particular interest, and their small size allows them to extravasate easily in the blood vessels penetrating deeper into the tumor vasculature. Incorporating USNBs with existing cancer therapies such as chemotherapy, immunotherapy, and/or radiation therapy in several preclinical models has been demonstrated to have a profound effect on solid tumors. In this review, we provide an understanding of the composition and formation of nanobubbles (NBs), followed by the recent progress of the therapeutic combinatory effect of USNBs and other cancer therapies in cancer treatment.

Electrostatic-Field-Induced Collapse of Nanobubbles in Nanochannels

The adsorbed nanobubbles inside the nanochannels can cause fluid transport blockages, which will obviously degrade the nanodevice performance and reduce the lifetime. However, due to small-scale effects, the removal of nanobubbles is a huge challenge at the nanoscale. Herein, molecular dynamics simulations are carried out to study the effect of the electrostatic field on underwater nitrogen nanobubbles confined in nanochannels. It is found that the nanobubbles will collapse under an appropriate electrostatic field, thereby unblocking the transport of water in the nanochannels. The formation of ordered water structures induced by electrostatic fields plays an important role in the removal of nanobubbles from the nanochannels. Our findings provide a convenient, controllable, and remote way to address the blockage problem of nanobubbles in nanochannels, which may have potential applications in improving the performance of fuel cells.

"Yin-Yang philosophy" for the design of anticancer drug delivery nanoparticles

Understanding the in vivo transport process provides guidelines for designing ideal nanoparticles (NPs) with higher efficacy and fewer off-target effects. Many factors, such as particle size, morphology, surface potential, structural stability, and etc., may influence the delivering process of NPs due to the existence of various physiological barriers within the body. Herein, we summarise the distinct influences of NP physicochemical properties on the four consecutive in vivo transport steps: (1) navigating with bloodstream within blood vessels, (2) transport across vasculature walls into tumour tissues, (3) intratumoural transport through the interstitial space, and (4) cellular uptake & intracellular delivery by cancerous cells. We found that the philosophy behind the current consensus for NP design has certain similarities to the "Yin-Yang" theory in traditional Chinese culture. Almost all physicochemical properties, regardless of big or small sizes, long or short length, positive or negative zeta potentials, are double-edged swords. The balance of potential benefits and side effects, drug selectivity and accessibility should be fully considered when optimising particle design, similar to the "Yin-Yang harmony". This paper presents a comprehensive review of the advancements in NPs research, focusing on their distinct features in tumour targeting, drug delivery, and cell uptake. Additionally, it deliberates on future developmental trends and potential obstacles, thereby aiming to uncover the ways these characteristics influence the NPs' biological activity and provide theoretical guidance for the targeted delivery of NPs.

Nanoscale contrast agents: A promising tool for ultrasound imaging and therapy

Nanoscale contrast agents have emerged as a versatile platform in the field of biomedical research, offering great potential for ultrasound imaging and therapy. Various kinds of nanoscale contrast agents have been extensively investigated in preclinical experiments to satisfy diverse biomedical applications. This paper provides a comprehensive review of the structure and composition of various nanoscale contrast agents, as well as their preparation and functionalization, encompassing both chemosynthetic and biosynthetic strategies. Subsequently, we delve into recent advances in the utilization of nanoscale contrast agents in various biomedical applications, including ultrasound molecular imaging, ultrasound-mediated drug delivery, and cell acoustic manipulation. Finally, the challenges and prospects of nanoscale contrast agents are also discussed to promote the development of this innovative nanoplatform in the field of biomedicine.

Ultrasound generation in water via quasi-periodically snapping polymeric core-shell micro-bead excited with radiowaves

This work reports the results of a theoretical and numerical study showing the occurrence of stochastically resonating bistable dynamic in polymeric micro-bead of sub-micrometric size with stiff core and soft shell. The system, submerged in water, is excited with a pulsed laser working in the Mega-Hertz frequency range and tuned to match both an optical and acoustic resonance of the system. The laser interacts with the carbon nanotubes embedded in the shell of the polymeric micro-bead generating heat. The concurrent action of the generated heat with the standing acoustic oscillations, gives rise to a stochastically resonating bistable system. The system in fact is forced to switch between two states (identifiable with the creation and organized disruption of a quasi-hexagonal tessellation) via a snap-through-buckling mechanism. This phenomenon results in the unprecedented generation of pressure oscillations. These results open the way to develop a new type of core-shell micro-transducers for radioacoustic imaging applications able to work in the Mega-Hertz frequency range. From a more general thermodynamic perspective, the reported mechanism shows a remarkable periodicity and energy conversion efficiency.

Effect of nanobubble concentrations on fouling control capacity in biogas slurry wastewater distribution systems

Nanobubble (NB) represents a promising practice for mitigating fouling in biogas slurry distribution systems. However, its anti-fouling effectiveness and optimal use dosage are unknown. This study investigated the NB anti-fouling capacity at six concentrations (0 %-100 %, denoting the ratio of maximum NB-infused water; particle concentrations in 0 % and 100 % ratios were 1.08 × 107 and 1.19 × 109 particles mL-1, respectively). Results showed that NB effectively mitigated multiple fouling at 50 %-100 % ratios, whereas low NB concentration exacerbated fouling. NB functioned both as an activator and a bactericide for microorganisms, significantly promoting biofouling at 5 %-25 %, and inhibiting biofouling at 50 %-100 %. Owing to an enhanced biofilm biomineralization ability, low NB concentration aggravated precipitate fouling, whereas high NB doses effectively mitigated precipitates. Additionally, higher NB concentrations demonstrated superior control efficiency against particulate fouling. This study contributes insights into NB effectiveness in controlling various fouling types within wastewater distribution systems.

Nonlinear Frequency Mixing Ultrasound Imaging of Nanoscale Contrast Agents

OBJECTIVE

Nanoscale ultrasound contrast agents show promise as alternatives for diagnostics and therapies due to their enhanced stability and ability to traverse blood vessels. Nonetheless, their reduced size limits echogenicity. This study introduces an enhanced nanobubble frequency mixing ultrasound imaging method, by capitalizing on their nonlinear acoustic response to dual-frequency excitation.

METHODS

A single broadband transducer (L12-3v) controlled by a programmable ultrasound system was used to transmit a dual-frequency single-cycle wavefront. The frequency mixing effect enabled simultaneous transducer capture of nanobubble-generated sum and difference frequencies in real time without the need for additional hardware or post-processing, by substituting the single-frequency wavefront in a standard contrast harmonic pulse inversion imaging protocol, with the dual-frequency wavefront.

RESULTS

Optimization experiments were conducted in tissue mimicking phantoms. Among the dual-frequency combinations that were tested, the highest contrast was obtained using 4&8 MHz. The nanobubble contrast improved with increased mechanical index, and achieved a maximal contrast improvement of 8.4 ± 0.5 dB compared to 4 MHz pulse inversion imaging. In imaging of a breast cancer tumor mouse model, after a systemic nanobubble injection, the contrast was improved by 3.4 ± 1.7, 4.8 ± 1.8, and 6.3 ± 1.6 dB for mechanical indices of 0.04, 0.08, and 0.1, respectively.

CONCLUSION

Nonlinear frequency mixing significantly improved the nanobubble contrast, which facilitated their imaging in-vivo.

SIGNIFICANCE

This study offers a new avenue to enhance ultrasound imaging utilizing nanobubbles, potentially leading to advancements in other diagnostic applications.

Exploring the potential of contrast agents in breast cancer echography: current state and future directions

Breast cancer stands as the most frequent malignancy and leading cause of death among women. Early and accurate detection of this pathology represents a crucial factor in enhancing both incidence and mortality rates. Ultrasound (US) examination has been extensively adopted in clinical practice due to its non-invasiveness, affordability, ease of implementation, and wide accessibility, thus representing a valuable first-line diagnostic tool for the study of the mammary gland. In this scenario, recent developments in nanomedicine are paving the way for new interpretations and applications of US diagnostics, which are becoming increasingly personalized based on the molecular phenotype of each tumor, allowing for more precise and accurate evaluations. This review highlights the current state-of-the-art of US diagnosis of breast cancer, as well as the recent advancements related to the application of US contrast agents to the field of molecular diagnostics, still under preclinical study.

Nanobubble-mediated cancer cell sonoporation using low-frequency ultrasound

Ultrasound insonation of microbubbles can form transient pores in cell membranes that enable the delivery of non-permeable extracellular molecules to the cells. Reducing the size of microbubble contrast agents to the nanometer range could facilitate cancer sonoporation. This size reduction can enhance the extravasation of nanobubbles into tumors after an intravenous injection, thus providing a noninvasive sonoporation platform. However, drug delivery efficacy depends on the oscillations of the bubbles, the ultrasound parameters and the size of the target compared to the membrane pores. The formation of large pores is advantageous for the delivery of large molecules, however the small size of the nanobubbles limit the bioeffects when operating near the nanobubble resonance frequency at the MHz range. Here, we show that by coupling nanobubbles with 250 kHz low frequency ultrasound, high amplitude oscillations can be achieved, which facilitate low energy sonoporation of cancer cells. This is beneficial both for increasing the uptake of a specific molecule and to improve large molecule delivery. The method was optimized for the delivery of four fluorescent molecules ranging in size from 1.2 to 70 kDa to breast cancer cells, while comparing the results to targeted microbubbles. Depending on the fluorescent molecule size, the optimal ultrasound peak negative pressure was found to range between 300 and 500 kPa. Increasing the pressure to 800 kPa reduced the fraction of fluorescent cells for all molecules sizes. The optimal uptake for the smaller molecule size of 4 kDa resulted in a fraction of 19.9 ± 1.8% of fluorescent cells, whereas delivery of 20 kDa and 70 kDa molecules yielded 14 ± 0.8% and 4.1 ± 1.1%, respectively. These values were similar to targeted microbubble-mediated sonoporation, suggesting that nanobubbles can serve as noninvasive sonoporation agents with a similar potency, and at a reduced bubble size. The nanobubbles effectively reduced cell viability and may thus potentially reduce the tumor burden, which is crucial for the success of cancer treatment. This method provides a non-invasive and low-energy tumor sonoporation theranostic platform, which can be combined with other therapies to maximize the therapeutic benefits of cancer treatment or be harnessed in gene therapy applications.

Bubble pulsation characteristics in multi-bubble systems affected by bubble size polydispersity and spatial structure

This study seeks to explore the bubble pulsation characteristics in multi-bubble environment with a special focus on the influences of the size polydispersity and the two-dimensional structure of bubbles. Three representative configurations of three interacting bubbles are formed by setting the initial radii of cavitation bubbles and inter-bubble distances appropriately, then the pulsation characteristics of a small bubble are investigated and compared by the bifurcation analysis. The results illustrate that the bubble size polydispersity and two-dimensional structure would greatly affect the bubble pulsations (i.e., the amplitude and nonlinearity of pulsations). Furthermore, the effects of two-dimensional structure are strong at a small inter-bubble distance of the large and small bubbles while the bubble size polydispersity always significantly affects the bubble pulsations for all cases. Moreover, the influences of both bubble size polydispersity and two-dimensional structure can be enhanced as the acoustic pressure increases, which can also become stronger when the large bubble is located at the same side as the small bubble and the initial radius of large bubble increases. Additionally, the effects would also be increased when the tissue viscoelasticity varies within a certain range. The present findings shed new light on the dynamics of multiple polydisperse microbubbles in viscoelastic tissues, potentially contributing to an optimization of their applications with ultrasound excitation.

QCM-D Investigations on Cholesterol-DNA Tethering of Liposomes to Microbubbles for Therapy

Lipid-shelled microbubbles (MBs) offer potential as theranostic agents, capable of providing both contrast enhancement in ultrasound imaging as well as a route for triggered drug release and improved localized drug delivery. A common motif in the design of such therapeutic vehicles is the attachment of the drug carrier, often in the form of liposomes, to the microbubble. Traditionally, such attachments have been based around biotin-streptavidin and maleimide-PDP chemistries. Comparatively, the use of DNA-lipid tethers offers potential advantage. First, their specificity permits the construction of more complex architectures that might include bespoke combinations of different drug-loaded liposomes and/or targeting groups, such as affimers or antibodies. Second, the use of dual-lipid tether strategies should increase the strength of the individual tethers tethering the liposomes to the bubbles. The ability of cholesterol-DNA (cDNA) tethers for conjugation of liposomes to supported lipid bilayers has previously been demonstrated. For in vivo applications, bubbles and liposomes often contain a proportion of polyethylene glycol (PEG) to promote stealth-like properties and increase lifetimes. However, the associated steric effects may hinder tethering of the drug payload. We show that while the presence of PEG reduced the tethering affinity, cDNA can still be used for the attachment of liposomes to a supported lipid bilayer (SLB) as measured via QCM-D. Importantly, we show, for the first time, that QCM-D can be used to study the tethering of microbubbles to SLBs using cDNA, signified by a decrease in the magnitude of the frequency shift compared to liposomes alone due to the reduced density of the MBs. We then replicate this tethering interaction in the bulk and observe attachment of liposomes to the shell of a central MB and hence formation of a model therapeutic microbubble.